Mobile Treatment, Diagnostic and Minor Surgery Facility

ABSTRACT

The invention is directed to a mobile medical facility capable of treating, diagnosing and performing minor surgery on multiple patients at one time. In general, the facility includes a health care area which is interchangeable between a first transportable configuration and a second, operational configuration. In the operational configuration, the health care area is expanded and capable of providing general care or diagnostic facilities to multiple patients as well as registration, counseling and triage to at least one patient. Preferable a row of patient treatment bays are provided with intake, counseling and triage cubicles and storage areas.

REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.13,681,454 filed Nov. 20, 2012, which issued as U.S. Pat. No. 8,733,813on May 27, 2014, and claims priority to U.S. Provisional Application No.61/588,814 filed Jan. 20, 2012, and U.S. Provisional Application No.61/561,963 filed Nov. 21, 2011, all of the same title and each of whichis incorporated by reference in its entirety.

BACKGROUND

1. Field of the Invention

A mobile treatment, diagnostic and minor surgical procedure unit andmethods are described. In particular, the unit and methods facilitatethe diagnosis, treatment, study of epidemiological significance ofparticular symptoms, diseases or illnesses within a population as wellas the delivery of primary care, analytic testing, and services tocommunities and people and isolated populations in need.

2. Description of the Background

Delivery of primary care is an important component of public healthcare, especially in developing countries or other areas where access tomedical services is challenging or prohibitive. Primary care istypically a point of first contact when it comes to the health of aparticular individual or population. This type of consultation addressesthe widest scope of health care by including patients of all ages and avariety of health care needs. Thus, primary care is often the basis ofan effective health care system.

Within the context of primary care, there can be epidemiologicalconcerns and vice versa. For example, studying the nature, time andduration of symptoms, signs, illnesses as well as treatments anddiagnoses from a community or population perspective is often crucialfor understanding the clinical significance of risk factors in thecommunity, the absolute risk associated with interventions or riskfactors, and the efficient targeting of preventive and other resources.Further, tailored advice can be provided to individual patients/familiesduring the consultation. Changes in the shape of primary care, and therange of symptoms and illnesses managed by different members of theprimary health care team, can influence understanding of: theepidemiology of disease in the community; the need for different healthcare services; and how epidemiology is performed.

Typically, temporary fixed medical facilities are established fordisaster medical care, e.g., in the event of a natural disaster or anepidemic outbreak in a given geographic region, or to augment existinghealth care structures at times of building infrastructure or performingrenovations. The effectiveness of any temporary medical facility isdependent on the readiness and rapidity with which such assets areprepared to evaluate patients once established. The appropriateequipment for the deployment mission, ease of use, and staff to providecare is all equally important considerations. While fixed, staticstructures, such as hospitals and clinics, are essential to communities;locations for such structures are typically reserved for the mostpopulated areas. This situation is clearly not beneficial for thoseliving outside this service area or in remote locations. In countrieswhere travel is on foot, these challenges to health and medical careresources are especially problematic.

In light of this dilemma, providing a portable medical facility that canreinforce or augment the existing local medical facilities and providebasic medical services and care would be advantageous according to thepresent invention described below. In particular, such facilities can beimportant in diagnostics, specifically, understanding disease spread andepidemiological surveillance. Targeting certain diseases andestablishing definitive diagnoses increases the likelihood that accuratetreatment options are known and available earlier in the course of aparticular illness or outbreak of illness, thus increasing the potentialfor positive outcomes.

SUMMARY OF THE INVENTION

In general, the invention is directed to a mobile treatment, diagnostic,and minor surgery unit adapted to treat, diagnose, or operate on aplurality of patients and adapted to be transported, including: a healthcare area including a floor area and adapted to interchange between atleast a first transport configuration and a second operationalconfiguration, wherein in the first configuration the floor area of thehealth care area is reduced compared to the second configuration toallow for transport of the health care area, and wherein in the secondconfiguration the health care area supports a first medical treatment,diagnostic, and minor surgical procedure patient area configured toprovide general care or diagnosis facilities to a plurality of patientsand a second patient area configured to provide registration,counseling, or triage to a least one patient.

In one embodiment, the mobile treatment, diagnostic and minor surgeryunit, the health care area includes one slide out area that is adaptedto expand and contract the health care floor area.

In another embodiment, the mobile treatment, diagnostic and minorsurgery unit when in the second configuration, the first medicaltreatment, diagnostic and minor surgical procedure patient area includesa single row of a plurality of patient treatment bays.

In another embodiment, each patient treatment bay includes either apatient bed or chair and, in the second configuration, the secondpatient area includes at least one cubicle designed for registration,counseling, or triage.

In another embodiment, the health care area of the mobile treatment,diagnostic and minor surgery unit is at most about 80 percent of themaximum size limit allowed to be transported over interstate roadways inthe United States.

In another embodiment, the health care area is at most 75 percent of themaximum size limit allowed, in yet other embodiments at most 70 percentof the maximum size limit allowed and in yet still other embodiments, atmost 65 percent of the maximum size limit allowed.

In another embodiment, the mobile treatment, diagnostic and minorsurgery unit further includes a transport system for moving the unit.

In another embodiment, the mobile treatment, diagnostic and minorsurgery unit further includes an awning system configured to be deployedto provide an extended patient care work environment adjacent to one orboth sides of the health care area.

In another embodiment, the mobile treatment, diagnostic and minorsurgery unit further includes: a generator sized and dimensioned toprovide power to the mobile unit; and an air filtration systemsufficient to repeatedly filter an air supply to the unit when deployedin the operational configuration, wherein the air filtration systemmaintains the air pressure inside the unit at a higher level than theair pressure outside the unit to at least minimize contamination in theunit.

In another embodiment, the mobile treatment, diagnostic and minorsurgery unit further includes at least one heating source to provideheat to the mobile unit and at least one air conditioning source to coolthe unit.

In another embodiment, the floor area in the second configuration of themobile treatment, diagnostic, and minor surgery unit is at least twiceas large as the floor area in the first configuration.

The invention further encompasses a mobile treatment, diagnostic andminor surgery facility adapted to be transported over any region that isaccessible by truck, four wheel drive or all-terrain vehicle. Preferablythe facility is vehicle, the vehicle chassis or the trailer of a big-rigtruck and not connected to a vehicle with a hitch or other tow bar.Vehicles of the invention travel on all manner of paved and unpavedroads including but not limited to U.S. interstate, non-U.S. and localroads and freeways, fire access roads in wooded areas, dirt paths,frozen rivers, swamps and bodies of water, gravel roads, ice roads,jungle paths, sand roads, pastures, salt flats, open desert, and anyterrain that is accessible by an all-terrain or four wheel drivevehicle. The facility provides treatment for a plurality of patientssuffering from a range of conditions or injuries including: a healthcare area having one slide out portion, a first transportableconfiguration defined by a contracted position of the slide out portion;a second operational configuration defined by an expanded position ofthe slide out portion; a first patient treatment area defined at leastpartially by the slide out that, when in the second configuration, isconfigured to provide general care to a plurality of patients and thatincludes a single row of a plurality of patient treatment bays; and asecond patient area at least partially defined by the slide out that, inthe second configuration, is adapted to provide registration,counseling, or triage to at least one patient, wherein the slide outportion has a floor area in the second configuration that is at leasttwice a floor area when the slide out portion is in the firstconfiguration.

In another embodiment, the mobile treatment, diagnostic and minorsurgery facility further includes a fixed awning system that extendsoutward from the health care area in at least one direction when thehealth care area is in the second, operational configuration, andprovides an extended patient care work environment adjacent to thehealth care area.

In another embodiment, the fixed awning system expands the capabilitiesof the facility to encompass one or more hospital litters, one or moresupply carts, a light source, and an electric source configured toextend one or more of the medical or diagnostic capabilities of themobile facility, or both, outside of the health care area. In furtherembodiments, the single row of the plurality of patient treatment baysincludes at most six patient treatment bays and the second area includesat least two cubicles for registration, counseling, or triage ofpatients, when the mobile unit is in the second, operationalconfiguration.

In another embodiment, the health care area includes a partition betweenthe first patient treatment area and the second registration,counseling, or triage patient area to facilitate control of movementbetween the first and second areas.

The invention further encompasses a method for providing medical care toa plurality of patients in a remote location including: transporting afirst health care area in a first transportable configuration from afirst location to a second remote location, wherein in the firstconfiguration the first health care area defines a first floor area andfacilitates the transport of the first health care area over one or moreroadways; expanding a slide out of the health care area to expand thehealth care area into a second operational configuration, wherein secondconfiguration of the health care area defines a second floor areagreater than the first floor area adapted to diagnose, treat, andperform minor surgery or first aid on a plurality of patients; providinga first medical treatment, diagnostic, and minor surgical procedurepatient area defined at least partially by the slide out within thesecond floor area; and providing a second patient area defined at leastpartially within the second floor area having at least one region thatis for registration, counseling, or triage.

In another embodiment, the method further includes contracting the slideout of the health care area to place the health care area back into afirst configuration for transport. In still other embodiments, themethod includes providing one or more separators for dividing each ofthe treatment bays for privacy therein.

In another embodiment, the method includes operably associating anextendable awning system with the health care area to increase themedical or diagnostic capability of the health care area, or both. Insome embodiments, the second patient area includes at least one of atable, a chair, and triage equipment.

Other embodiments and advantages of the invention are set forth in partin the description, which follows, and in part, may be obvious from thisdescription, or may be learned from the practice of the invention.

DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a perspective view of one embodiment of the presentinvention, wherein the health care area is in a first configuration fortransport to a location.

FIG. 2 illustrates a perspective view of one embodiment of the presentinvention wherein the health care area is in a second operationalconfiguration.

FIG. 3 illustrates a perspective view of one embodiment of a remotecontrol device for moving the health care area between the first andsecond configurations.

FIG. 4 illustrates a view one embodiment of the invention from theinterior of the health care area from the top wherein the health carearea is in a second operational configuration.

FIG. 5 illustrates a view one embodiment of the invention from theinterior of the health care area from the top wherein the health carearea is in a first transportable configuration.

FIG. 6 illustrates a rear view of one embodiment of the invention of thehealth care area in a second operational configuration.

FIG. 7 illustrates an expanded view of a cantilever beam and sleeve asshown in FIG. 6.

FIG. 8 illustrates an expanded view of a roller area on the bottom of aside end of the slide out that is shown in FIG. 7.

FIG. 9 illustrates a rear view of one embodiment of the invention of thehealth care area wherein the slide out is between the first and secondconfiguration.

FIG. 10 illustrates a rear view of one embodiment of the invention ofthe health care area wherein the slide out is in the first transportableconfiguration.

FIG. 11 illustrates a perspective view of one embodiment of theinvention of a first medical treatment, diagnostic, and minor surgicalprocedure patient area defined at least partially by the slide out in asecond operational configuration.

FIG. 12 illustrates perspective view of a mobile facility with atransparent exterior wall showing the interior structures and roomplacement.

DESCRIPTION OF THE INVENTION

The invention is directed to mobile treatment, diagnostic and minorsurgical procedure facilities, and also, methods to facilitate thediagnosis, treatment, study of epidemiological significance ofparticular symptoms, diseases or illnesses within a population as wellas the delivery of primary care, analytic testing, and services tocommunities and people and isolated populations in need. Preferably thefacility provides acute care to patients and populations and can bedeployed quickly, efficiently and cost effectively as compared to fixedstructures even when transported by truck or another vehicle. The mobiletreatment, diagnostic and minor surgery unit, also referred to as “unit”or “facility,” and methods described herein facilitate transport ofgeneral and/or primary care, diagnostic and minor surgical equipment andservices to locations that are in need thereof. Treatment includes careprovided to a patient for any diagnostic or preventative procedure ordisorder who may be ill and presenting symptoms or be symptomless,including, but not limited to palliative care, such as treating achronic condition or one or more symptoms thereof, essential medicalcare, such as that which would be life-saving, and non-essential medicalcare, such as treatment of angina or other quality of life concerns.Diagnosis can be the identification of the cause of any particularmalady, and can include basic laboratory testing such as identifying apatient with diabetes by blood testing, or molecular analysis, e.g.,nucleic acid analysis of an influenza infected patient to confirmdiagnosis or obtain more specific strain or other information. In suchlocations, mobile health assets can advantageously improve wellness andfacilitate prevention strategies and can drastically improve the qualityof life for a population. The mobile unit described herein is adapted topermit treatment of numerous patients and have a high through-put ofpatients as compared to what is otherwise available in the area, ifanything. Preferably the mobile facility is not towed but self-propelledwith an engine which is preferably powered with gasoline, jet oraircraft fuel, diesel or bio-diesel fuel, ethanol, electric batterypower, compressed natural gas or a hybrid thereof. As such, the facilityis easily transported over conventional interstate highways, roads,unimproved roads such as, for example with off-road modifications (e.g.,all-wheel drive, four-wheel drive, individual or single wheel drive,Humvee), or transported by air or sea without requiring unusual orextensive transporting expense or effort even when transporting themobile unit to a remote location, such as a rural location or anunderdeveloped country or region. Accordingly, the facility may possess,for example, wheels for travel cross roads, skis for travel across snowand ice and possibly sand, a hull for travel across water, or tracks fortravel across rough terrain.

In particular, the invention encompasses health care areas 15 that aresized and dimensioned to be smaller than a semi-trailer so as to fit onsuch a smaller vehicle and therefore be more readily transportableoff-road and to other remote locations in need of such a mobilehealthcare unit. In such embodiments, the mobile facility can bedelivered and deposited at a location, and the cab recovered or simplyused elsewhere. When the desired mission of the facility is completed,the facility can be simply and easily re-connected to a cab and againtransported to a new location. Because transportation is so easy, thefacility can also be brought to a convenient location for cleaning,replenishment of supplies (as opposed to supplies having to be deliveredto the facility), refurbishment of furniture or equipment, or for anyreason. Also in such embodiments, the mobile facility can be constructedat a particular remote site, for example, by air drop or ship deliveryof unit parts that are constructed and the constructed vehicle drivenaway. By allowing for unit construction on site, problems associatedwith transport over undesirable areas can be eliminated and/or themobile facility can be constructed for the specific transportation needsrequired without component parts that are not necessary for transport inthe target or designated area. Vehicle wheel suspension is preferablyindependent and utilizes designs encompassing non-Newtonian fluids.Preferably the walls of the mobile facility are composed of a materialthat is lighter in weight than iron or steel, such as aluminum, carbonfiber or another weather resilient and relatively inert material. Alsopreferably, the exterior walls of the facility are insulatedsufficiently to maintain an interior temperature that is suitable fortreatment of the patients and protective from weather, such as wind,lightning, water and temperatures that are considered hot or cold ascompared to ambient.

Preferably, and when necessary, the mobile facility possesses all of therequired accessories, features and/or attributes to be registerable fortravel across roads of the country or region of interest. Alsopreferably the mobile facility contains a sleeper cab for the driverand/or additional passenger to rest when extended travel times make restor travel breaks necessary or desired.

In general, and as shown in FIG. 1, the unit 10 includes a health carearea 15 and an operationally associated transport system 30. The healthcare area 15 includes most, if not all, of the treatment, diagnostic andminor surgical equipment. The transport system 30 may be associated withthe health care area 15 by any means known to one of ordinary skill inthe art. For example, the transport system 30 may be a truck, cab ortractor that is coupled to the health care area by a number ofmechanisms, such as by use of hitch, hook and lock mechanisms, convertergear, etc. In this preferred embodiment, the transport system 30 mayreversibly coupled to the health care area 15 so that the health carearea can be delivered to an area in need. The transport system 30 mayadditionally provide energy and air to the health care area 15 throughair and electric lines. In an additional embodiment, the transportsystem 30 may be directly attach to the health care area 15, so that thetransport system 30 and the health care area form one unified structure,such as a large van. Both the transport system 30 and the health carearea typically have wheels 25 to allow for ease of transport overroadways, although the health care area 15 can be outfitted to betransported easily via transport vehicles over air and water as well,such as is typical in the transport of storage containers.

The health care area contains various pieces of electrically poweredequipment that are connected to a power source such as an alternatorcoupled to the engine of the vehicle or, preferably, by a generatorcoupled to a fuel supply such as, but not limited to, propane, naturalgas, diesel fuel, ethanol, gasoline, or combinations thereof. The powersource may be used to run the electrical equipment within the facility(e.g., medical equipment, air filtration system, air conditioning,heating, lighting, water pumps, etc.), to provide power to externalconnections, and to power the vehicle itself, such as expandableportions of the facility (e.g., awning, flooring, walls) and/or thevehicle engine or another engine.

Preferably, the floor area created by the expanded configuration is atleast 25% greater and, more preferably, at least 50% greater than thefloor area of the contracted configuration. Also, preferred is a floorarea in the expanded configuration that is at least 75% greater, atleast 100% greater, at least 125% greater, at least 150% greater, atleast 175% greater and 200% greater or more than the floor area of thecontracted configuration. Also preferred is an expanded configurationthat provides more than expanded floor area, but also increased the workarea such as, for example, by providing increased working area (e.g.,chairs, desks, beds, benches, shelves) at multiple levels in theexpanded configuration.

As shown in FIGS. 1 and 2, the health care area 15 has at least a firstand second configuration. This is accomplished by the use of at leastone slide out 20, and preferably only one slide out 20. The slide out 20is able to reversibly expand and contract in size and has more than oneposition to allow for the different configurations of the treatment anddiagnostic regions within the health care area 15. In the firstconfiguration, the floor area of the health care area 15 is typicallyreduced to a size that allows for the transporting of the facility suchas a trailer over, for example, public highways and pathways, as thesecond configuration is often too large to fit in a standard-sizedinterstate vehicle or container. In fact, in a preferred set ofembodiments, the first configuration is sufficiently small that it canreadily fit in vehicle smaller and preferably at least substantiallysmaller, than a semi-trailer-sized vehicle for interstate travel. In thesecond configuration, the floor area of the health care area 15 isexpanded and large enough to support a plurality of beds for treating ordiagnosing patients, and an area for registration, counseling, ortriaging of patients. For example, the treatment area may have up to sixbeds when the slide out 20 is in an expanded position. In someembodiments, the floor area in the second configuration may be largerthan the floor area in the first configuration, preferably the floorarea of the health care area 15 in the second, expanded configuration isat least twice the size of the floor area of the health care area 15 inthe first, contracted configuration.

Preferably there exist multiple expanded configurations for any or allexpanded areas (e.g. awning, walls, ceilings, floors) such thatexpansion from the contracted configuration can be incremental allowingfor expansion to a size or area that accommodates to the surroundings.With incremental expansion, there can be a first expanded configuration,a second further expanded configuration, a third still further expandedconfiguration, and so on as desired wherein each incremental expansioncan be functional and utilized. Each incremental expansion is preferablylocked in place before use. Similarly, there may be a first, a second, athird, and so on contracted configurations.

Preferably, patients are serviced in the expanded configuration and thecontracted configuration is for transportation and contains no patientsor other health care providers. A contracted configuration thatmaintains a small number of patients and/or health care workers duringtransportation is also preferred.

In general, the health care area 15 may be of any shape compatible withits treatment, diagnostic or minor surgical function but preferably, inthe first configuration the shape of the health care area 15 isgenerally rectangular and includes side walls 40, a roof surface 45, aback surface 35 and an undersurface 50. The back surface 35 may includeat least one door 65 for entry into the health care area 15, oralternatively may include an additional slide out for expansion of thehealth care area 15. Preferably the facility possesses 2, 3, 4, 5, 6, 7,8, 9 or 10 or more beds, recovery rooms or suites (or more), which maybe individually configured as private or semi-private, for temporary orovernight patients, or a number of beds as determined by the structureand lay out of the facility. Although the mobile facility can be parkedand immediately utilized, alternatively the mobile unit may be connectedsecurely to the ground or another object or objects for stability.Preferably, all connections are reversible such that connections can beunsecured and the mobile facility moved to a new location as desired.

In one embodiment, the slide out 20 emerges from the side wall 40 whenthe health care area 15 is expanding into the second configuration. Thismay be controlled by remote control 90 as is shown in FIG. 3. While inthe first configuration, the health care area 15 may generally be of anysize but is preferably sized to fit on common roadways while intransport. Preferably, and advantageously for smaller roadways, the sizeof the health care area 15 in the first configuration is reduced ascompared to the maximum transport size allowed on roadways. For example,and not by way of limitation, the health care area 15 may be 80 percentof the maximum size limit allowed to be transported over interstateroadways in the United States as determined by the Department ofTransportation in most instances. In other embodiments, the health carearea is at most 75 percent of the maximum size limit allowed, in yetother embodiments at most 70 percent of the maximum size limit allowedand in yet still other embodiments, at most 65 percent of the maximumsize limit allowed. For example, on interstates in the U.S., the maximumsize allowed is about 102 inches (2.6 m) wide, 13.5 feet (4.1 in) feetin height, and 80,000 pounds (36,000 kg) gross weight. Preferably, thetransport system and health care area are sized to fit in a truck thatis shorter than a semi-trailer truck, preferably in a standard-sizedtruck, including but not limited to sizes in length of about: 10 feet,14 feet, 16 feet, 17 feet, 20 feet, 24 feet, 26 feet, 30 feet, 35 feet,or the like, or any size there between. Also preferred is a system thatinvolves multiple trailers with different purposes such as, for example,a first trailer that serves as a preparatory room for minor surgicalprocedures, examinations, and/or discussions, and a second trailer formore involved procedures and a third containing recovery beds or suitesas needed, which may be 1, 2, 3, 4, 5, 6 or more. Trailers may alsocontain both surgical and recovery beds in the same vehicle.

In the second, expanded configuration, the health care area 15 isexpanded and provides additional floor area capable of supporting aplurality of patient treatment bays 95 and a plurality of cubicle areas100 for registration, counseling or triage of patients. The health carearea 15 is expanded by the use of one or more slide outs 20. In apreferred embodiment, the health care area 15 has one slide out.

The health care area 15 may include one or more doors for entering andleaving. For example, the back surface 35 of the health care area 15 maydefine one or more doors 65 and serve as a main entrance 85. A ramp 75and/or stairs 80 may be transported with the health care area 15 andused to assist people in reaching the main entrance 85. In addition, ahydraulic lift 70 may be transported with and attached to the backsurface 35 of the health care area 15 to assist in transportingequipment into and out of the health care area 15. Additional oralternative zones for ingress or egress may also be present, e.g., onthe sides of the health care area.

The health care area 15 may further include a satellite communicationsystem 60 for the unit 10. The satellite communication system 60 mayprovide real-time video and audio communications between the unit 10 andother health or governmental agencies such as emergency centers. Thesatellite communication system 60 can also allow for internetcapabilities as well as the transport of information, preferablyencrypted to comply with governmental regulations regarding such privateinformation, such as medical records to and from the unit 10.Telemedicine capabilities, such as videoconferencing, can also beprovided for by using the satellite communication system 60.

When the slide out 20 is fully extended, it in part defines a firstpatient area adapted to diagnose, treat and/or perform minor surgery orfirst aid on a plurality of patients concurrently or sequentially, aswell as a second patient area for registering, counseling or performingtriage on at least one patient. The first patient area includes themedical and/or diagnostic equipment for addressing, treating, ordiagnosing a wide range of conditions or injuries including, but notlimited to, minor operative procedures, defined as those not requiringgeneral anesthesia or deep sedation such as skin lesion biopsy, woundrepair, abscess incision and drainage, and circumcision.

As shown in FIG. 4, the first patient area provides for a plurality ofpatient treatment bays 95. At most, six patient treatment bays 95 areprovided for within the health care area 15. In some instances, six,five, four, three, two or even one patient treatment bay 95 is provided.Some of the patient bays 95 may be designated for diagnostic sampling,treatment or minor surgical procedures. Alternatively, bays may bedesignated or used for multiple purposes, e.g., diagnosis and treatment,or diagnosis and surgery, or even all three purposes. Each patient bay95 may include a patient bed, chair or hospital litter, and additionalmedical or diagnostic equipment. Such equipment can include typicalsupplies found within a general practitioner's office, such as samplecollection equipment, pressure cuffs, thermometers, etc. as well asequipment found within an analysis laboratory, such as polymerase chainreaction machines, hot water baths, culturing equipment, test strips,medical workstation, and the like. Thus, medical personnel may be ableto diagnose an ongoing infectious epidemic within a population withouthaving to send samples away from the mobile unit 10. Patient beds may betypical of those found in medical offices. The patient treatment bays 95may be divided for privacy by the use of partitions, such as walls,curtains, screens, pull-down shades, or the like. The second patientarea may provide one or more cubicles 100 for the registration,counseling or triage of one or more patients. As shown in FIG. 4, twocubicles 100 and six patient treatment bays are a preferred embodiment,although one in the art would appreciate that numerous variations thepresent invention may be employed regarding the number, combination anddesignation of the patient treatment bays 95 and the cubicles 100. Eachcubicle 100 may include chairs, a desk and/or additional equipmentincluding that discussed herein. Thus, typically patients will beregistered and evaluated as to the severity of their condition withinthe context of the second patient area. The patient would then beevaluated by a medical professional or samples would be taken within thefirst patient area. There may be a partition 110 between the two areasso as to provide for a division of services provided within the areas,as well as enhance the privacy of the patients, including thosealternatives noted above.

The general area 105 not occupied by the patient treatment bays 95 andthe cubicles 100 may provide storage area or laboratory space, asneeded, and may include one or more sinks. In some embodiments, thisarea may be used as a pharmacy. The pharmacy may have sufficientpharmaceutical supplies for treatment regimen(s) for up to about fourweeks, in some instances up to about three weeks, in other embodiments,up to about one or two weeks. Preferably, there is a plurality oftreatment courses so that multiple patients with the same diagnosis canreceive appropriate pharmaceuticals in association with treatment ordiagnosis at the mobile unit 10. Thus, the unit 10 is able to supply apopulation or community with necessary medicine during an initialoutbreak until longer term medical units arrive in the area. Forexample, during an influenza epidemic, the pharmacy may be stocked withenough TAMIFLU® (an antiviral medication) to treat the initiallyinfected population, e.g., for about one to three days until additionalsupplies can be shipped to the mobile unit or a nearby site. Also, inthe general area 105 may be one or more medical workstations 115.Alternatively, minor surgical procedures and diagnostics can beperformed such as, for example, cervical and other cancer screening, eyeand ear examinations, neonatal care, circumcisions, minor and traumaticinjury care, nutritional screening, blood testing and analysis,pulmonary diagnosis, tropical medicine care such as screening, diagnosisand treatment of parasitic infections common to local areas, and manyothers. The workstations 115 may consist of a desk type structure withadditional storage space and a work surface. Medical personnel may fillout charts and prescriptions, as well as consult with other personnel atthese workstations. Some workstations may be outfitted with a computerfor input of medical or epidemiological data.

As shown in FIG. 5, the workstations 115 may remain in place even whenthe health care area 15 is in a first contracted configuration. Theworkstation may be a records database terminal or computer with accessto, e.g., a database of treatment procedures, diagnosis information ordiagnostic or treatment knowledge base, or patient records, or anycombination thereof. Additional equipment at each patient treatment bay95 or cubicle 100 may include cabinetry for storage 130, which mayremain in place or move outward when the health care area 15 is in asecond expanded configuration. The unit may also include supply cartsfor storing and moving supplies. For example, the carts may includeairway support supplies, intravenous lines, and treatments for minorlaceration and burn care as well as pharmaceuticals. Portable diagnosticmachinery, such as ultrasound equipment, may also be provided on thecart.

At one end of the health care area 15 when it is in a first contractedconfiguration, there may be an entry area 130 in which to store entrywaymaterials such as doors, hydraulic lifts and ramps that can beoperatively associated with the mobile unit 10 when in the secondconfiguration. In addition, near the back surface 35 and the surfaceopposite the back surface 35, there may be sealing flanges 125 for theslide out. The sealing flanges 125 extend generally perpendicular fromboth the ceiling and side of the slide out and are generally parallelwith the side wall 40 of the health care area 15. The sealing flanges125 facilitate the sealing of the health care area 15 when the slide out20 is expanded.

As shown in FIG. 6, the outer wall 175 of the slide out is substantiallyparallel to the side wall 40 of the health care area 15. Each slide out40 generally includes an outer wall 175, a ceiling 180 and twoconnecting walls. The outer wall 175 may be substantially planar withthe side wall 40 of the health care area 15. When in a firstconfiguration, the ceiling 180 and two connecting walls aresubstantially included within the side wall 40. One or more rollers 185may be affixed to the top of the floor 140 of the health care area 15,e.g., below the slide out 20. The rollers 185, which could be lowfriction material inserts, tapered or cylindrical or spherical elements(e.g., ball bearings), or the like, can facilitate the movement of theslide out over a floor 140 of the health care area 15 when the slide out40 is moving between configurations. The movement typically involvessliding the slide out, but could involve rolling or other movement orcombinations thereof. The floor 140 of the health care area 15 hasseveral sections that are adjustable to accommodate the slide out 40movement. For example, the floor 140 between the side walls 40 of thehealth care area 15 has several sections that can be adapted to fold 170when the slide out 40 is in the first configuration and several sectionsthat remain solid and do not fold 145, or do not readily fold, when theslide out is in the second configuration. In one embodiment, as shown inFIGS. 9 and 10, two sections of the floor can be adapted to fold up 170to approximately 90 degrees in the first configuration and to extend toand flatten out to about 180 degrees in the second configuration.

The health care area 15 may include a plurality of hydraulic rams withcylinders and pistons for moving the slide out 20 betweenconfigurations. These hydraulic rams may be controlled by a remotecontrol 90, as shown in FIG. 4. Each cylinder can be located between thenon-folding floor section 145 and the undersurface 50 of the health carearea 15. An end of the piston can be attached to the outer wall 175 ofthe slide out underneath the floor. One of ordinary skill in the artwould appreciate that, although the use of hydraulic rams isexemplified, other methods and devices, such as a rack and pinion gearsystem, hand cranks or electric motors, actuators, or other such devicesor combinations of devices could be used to move the slide out 20 intothe different configurations.

The health care area 15 may also include a plurality of structuralsupports for the slide out 20 when it is in the second configuration.For example, one or more cantilever beams, jack supports, or acombination thereof, may be used. As seen in FIGS. 6 through 9, thehealth care area 15 may have a plurality of cantilever supports 150.Each support includes a sleeve 155, a beam 165, and one or more rollers185. The sleeve is typically disposed beneath one of the non-foldingfloor sections 145 and can be attached to the floor 200 of the healthcare area 15 and the side end 205 of the slide out 20. The sleeve 155 isable to include some or the entire beam 165. One end of the beam 165 isfixed to the outer wall 175 of the slide out. When the slide out 20extends out, the beam 165 extends out of the sleeve 155 along with itand when the slide out 20 contracts, the beam 165 can retract back intothe sleeve 155 as well. The rollers 185 engage the beam 165 throughopenings 195 and facilitate the movement of the beam 165 into and out ofthe sleeve 155. Wires 190 may help control the speed at which the beamextends and contracts. The health care area 15 may also include aplurality of jack supports 160 for additional support to the slide out20. The jack supports 160 are placed at or near the outer wall 175 ofthe slide out. The jack supports 160 can be configured to engage one endof the beam 165, although many other configurations could becontemplated by one of ordinary skill in the art.

As shown in FIGS. 9 and 10, a plurality of latitudinal supports 210 canbe integrally formed or attach to each folding floor section 170. Eachlatitudinal support 210 has at least two ends; one adjacent to thefolding floor section 170 and one adjacent to the non-folding floorsection 145. A bracket, typically U-shaped, 215 connects the at leasttwo ends and allows the folding floor section 170 to rotate or foldupwardly without interference from the non-folding floor section 145. Aplurality of stationary gears 220 is attached to the other end of thelatitudinal support 210 adjacent to another folding floor section 170.These gears 220 facilitate the movement of the two folding floorsections 170. In addition, the health care area 15 may also beoperatively coupled with one or more hydraulic legs 225 adapted to levelor stabilize the health care area when it is in the secondconfiguration.

As shown in FIG. 11, the patient treatment bays 95 may include hospitallitters 230, lighting 235, and supplies that may be stored in a varietyof cabinets 120 in each bay 95. The patient treatment bays 95 may alsoinclude monitoring and diagnostic equipment. Oxygen, air suction, andelectricity can all be piped into the treatment bays 95. The layouts aredesigned to minimize time between different patients. Diagnosticinstruments such as ophthalmoscopes, otoscopes, sphygmomanometers, andthermometers can be found either within the bays 95 or nearby storageareas. Additionally, portable monitors could also be provided. Thehealth care area 20 may also include power generation, running potablewater, biohazard waste disposal, heating, air conditioning, and HEPA airfiltration.

The mobile treatment, diagnostic, and minor surgical unit 10 may alsoinclude an awning system for extending the area and capabilities of theunit 10. The awning system may surround the health care area 15 or theunit 10 in a tent-like mariner. A marquee or anchor for the awningsystem 55 may be placed on top of the health care area 15. A variety ofjoists and columns preferably made out of aluminum, carbon(nano)composite, or other similarly strong but lightweight material canprovide the support for the canvas, or other similarly weather-resistantmaterial that can form a portion of an awning system. Once in place, theawning system can be outfitted with lighting, cooling and heating units.Portable litters may be placed under the awning so as to allow formedical monitoring and basic treatment. Rolling carts with supplies canbe provided to aid in the provision of care. If necessary, the awningsystem provides an effective way of adding additional capacity,particularly when the remote location in which the mobile unit isarranged has a mild climate.

FIG. 12 illustrates a complete mobile facility with a transparent wallshowing room placement and the location and design of interiorcomponents.

In addition, a method for providing medical care to a plurality ofpatients in a remote location includes transporting a first health carearea in a first transportable configuration from a first location to asecond remote location is provided. As used herein “remote location” caninclude any location that is distant from a community health facility,such as a hospital, a community clinic or, in some instances, alaboratory. In the first configuration the first health care areadefines a first floor area and facilitates the transport of the firsthealth care area over one or more roadways. The slide out of the healthcare area is expanded to expand the health care area into a secondoperational configuration. The second configuration of the health carearea defines a second floor area greater than the first floor area andis adapted to diagnose, treat, and/or perform minor surgery or first aidon a plurality of patients. A first medical treatment, diagnostic, andminor surgical procedure patient area defined at least partially by theslide out within the second floor area is provided as well as a secondpatient area defined at least partially within the second floor areahaving at least one region that is for registration, counseling, ortriage. Separators for dividing each of the treatment bays may beprovided to enhance privacy. The second patient area may include atleast one of a table, chair and triage equipment. In some instances,methods can further include contracting the slide out of the health carearea back into a first configuration once the immediate need for theservices provided by the unit is satisfied. In other instances an awningsystem may be operably associated with the health care area so as toincrease the medical and/or diagnostic capability of the health carearea. For example, the awning system may be used where the population inneed is large, such as in situations of outbreak or duringepidemiological studies.

Other embodiments and uses of the invention will be apparent to thoseskilled in the art from consideration of the specification and practiceof the invention disclosed herein. The term comprising, where ever used,is intended to include the terms consisting and consisting essentiallyof. Furthermore, the terms comprising, including, and containing are notintended to be limiting. All references cited herein, including allpublications, U.S. and foreign patents and patent applications, and theU.S. Provisional Applications noted herein as priority document, arespecifically and entirely incorporated by reference. It is intended thatthe specification and examples be considered exemplary only with thetrue scope and spirit of the invention indicated by the followingclaims.

1. A mobile unit adapted to treat, diagnose and operate on multiplepatients and adapted for self-propelled transportation, containing: ahealth care area comprising a floor area adapted to interchange betweena transport configuration and an operational configuration, wherein thefloor area of the health care area in the transport configuration isreduced compared with the floor area of the health care area in theoperational configuration, and wherein the health care area in theoperational configuration supports a medical treatment, diagnostic andminor surgical procedure area configured to be able to provide medicalcare and medical diagnostic facilities to patients and a patient areaconfigured to be able to provide counseling and triage to patients; anda transport system coupled to the health care area as a unit comprisingan engine suitable for transport of the healthcare area, wherein thehealth care area in the transport configuration is no larger than themaximum size limit for transportation over a roadway on which the unitis deployed.
 2. The mobile unit of claim 1, wherein the health care areaincludes one slide out area that is adapted to expand and contract thehealth care floor area and, in the operational configuration, themedical treatment, diagnostic, and minor surgical procedure patient areaincludes a plurality of patient treatment bays.
 3. The mobile unit ofclaim 2, wherein each patient treatment bay includes either a patientbed or chair and, in the operational configuration, the patient areaincludes at least one cubicle designed for counseling and triage of thepatient.
 4. The mobile unit of claim 1, wherein the health care area isat most about 80 percent of the maximum size limit for transportationover roadways as determined by the roadway authority and in theoperational configuration contains at least 50% greater floor area thanthe transport configuration.
 5. The mobile unit of claim 1, wherein themobile unit is smaller than a semi-trailer truck and the floor area inthe operational configuration is at least twice as large as the floorarea in the transport configuration.
 6. The mobile unit of claim 1,further comprising an awning system configured to be deployed to providean extended patient care work environment adjacent to one or both sidesof the health care area.
 7. The mobile unit of claim 1, wherein the unitfurther comprises: a generator sized and dimensioned to provide power tothe mobile unit; and an air filtration system sufficient to repeatedlyfilter an air supply to the unit when deployed in the operationalconfiguration, wherein the air filtration system maintains the airpressure inside the unit at a higher level than the air pressure outsidethe unit to at least minimize contamination in the unit.
 8. The mobileunit of claim 1, which comprises wheels, skies, a hull, tracks or acombination thereof.
 9. The mobile unit of claim 1, which comprisesmultiple transport configurations or multiple operationalconfigurations, or multiple transport and operational configurations.10. The mobile unit of claim 1, wherein the unit further comprises atleast one heating source to provide heat to the mobile unit and at leastone air conditioning source to cool the unit.
 11. A mobile treatment,diagnostic, and minor surgery facility adapted to be transported over aroad and to treat a plurality of patients suffering from a range ofconditions or injuries comprising: a health care area having one slideout portion; a transportable configuration defined by a contractedposition of the slide out portion; an operational configuration definedby an expanded position of the slide out portion; a patient treatmentarea defined at least partially by the slide out that, when in theoperational configuration, is configured to provide general care to aplurality of patients and that includes a row of a plurality of patienttreatment bays; a patient processing area at least partially defined bythe slide out that, in the operational configuration, is adapted toprovide registration, counseling, or triage to at least one patient,wherein the slide out portion has a floor area in the operationalconfiguration that is at least twice a floor area when the slide outportion is in the transport configuration; and a transport systemcoupled to the health care area as a structure comprising an enginesuitable for transport of the healthcare area, wherein the health carearea is at most the maximum size limit for transportation over roadwaysas determined by a roadway authority.
 12. The mobile facility of claim11, further comprising a fixed awning system that extends outward fromthe health care area in at least one direction when the health care areais in the operational configuration, and provides an extended patientcare work environment adjacent to the health care area.
 13. The mobilefacility of claim 12, wherein the fixed awning system expands thecapabilities of the facility to encompass one or more hospital litters,one or more supply carts, a light source, and an electric sourceconfigured to extend one or more of the medical or diagnosticcapabilities of the mobile facility, or both, outside of the health carearea.
 14. The mobile facility of claim 11, wherein the row of thepatient treatment bays includes at most six patient treatment bays andthe patient processing area includes at least two cubicles forcounseling and triage of patients, when the mobile unit is in theoperational configuration.
 15. The mobile facility of claim 11, whereinthe health care area includes a partition between the patient treatmentarea and the patient processing area to facilitate control of movementbetween the treatment and processing areas.
 16. The mobile facility ofclaim 11, further comprising contracting the slide out of the healthcare area to place the health care area back into the transportconfiguration.
 17. The mobile facility of claim 11, further comprisingproviding one or more separators for dividing each of the treatment baysfor privacy therein.
 18. The mobile facility of claim 11, which furthercomprises operably associating an extendable awning system with thehealth care area to increase the medical or diagnostic capability of thehealth care area, or both.
 19. The mobile facility of claim 11, whereinthe patient processing area includes at least one of a table, a chair,and triage equipment.
 20. A method for providing medical care to aplurality of patients in a remote location comprising: transporting ahealth care area via a system coupled to the health care area as astructure, wherein the health care area is at most the maximum sizelimit for transportation over roadways and in the operationalconfiguration contains a greater floor area than the transportconfiguration, and in the transportable configuration from a firstlocation to a second location, wherein in the transport configurationthe first health care area defines a first floor area and facilitatesthe transport of the health care area over one or more roadways;expanding a slide out of the health care area to expand the health carearea into an operational configuration, wherein the operationalconfiguration of the health care area defines a second floor areagreater than the first floor area adapted to diagnose, treat, andperform minor surgery or first aid to multiple patients; providing afirst medical treatment, diagnostic, and minor surgical procedurepatient area defined at least partially by the slide out within thesecond floor area; and providing a second patient area defined at leastpartially within the second floor area having at least one region thatis for counseling and triage.